Corissa Lynn Bayer, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PY9440 Issued in FL

Practice address

3 Vine Ave NE
Fort Walton Beach, FL 32548-5069

Phone

(850) 226-7666

Fax

(850) 226-7499

NPI assigned

Nov 15, 2012

Last updated

Nov 25, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Other names 1

• Corissa Lynn Callahan Former name

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Bayer Neurobehavioral Center, PLLCGroup PAC ID 4981922747, 7 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Bayer Neurobehavioral Center, PLLC

  • Clinical Neuropsychologist
  • Fort Walton Beach, FL
  • NPI 1720470255
  Medicare reassignment Care Compare group NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1352937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574640000000",
    "number": "1790029783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 VINE AVE NE",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325485069",
            "telephone_number": "850-226-7666",
            "fax_number": "850-226-7499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 VINE AVE NE",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325485069",
            "telephone_number": "850-226-7666",
            "fax_number": "850-226-7499"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "216 Hospital Dr NE",
            "address_purpose": "LOCATION",
            "city": "Fort Walton Beach",
            "state": "FL",
            "postal_code": "325485068",
            "country_code": "US",
            "telephone_number": "850-226-7666",
            "fax_number": "850-226-7499",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BAYER",
        "first_name": "CORISSA",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-11-15",
        "last_updated": "2019-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "GA",
            "license": "3571",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY9441",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY9440",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CORISSA",
            "last_name": "CALLAHAN",
            "middle_name": "LYNN",
            "credential": "PHD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Bay Foot and Ankle Center PA
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• Bay Prosthetic Center
• Bayer and Curtis Orthodontics
• Bayer Neurobehavioral Center, PLLC
• Zachary Clark Bayer, PSYD
• Beach Orthopaedic & Sports Medicine Clinic, PA
• Glynis Bealer
• Elizabeth Ann Beaver
• Lynn Kelly Beck, MS, LMHC

• Clinical Psychologist in Fort Walton Beach, FL
• Providers in Fort Walton Beach, FL by specialty
• Clinical Psychologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.